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Sen RK, Prabhakar P, Shruti, Verma P, Vikram A, Mishra A, Dwivedi A, Gowri VS, Chaurasia JP, Mondal DP, Srivastava AK, Dwivedi N, Dhand C. Smart Nanofibrous Hydrogel Wound Dressings for Dynamic Infection Diagnosis and Control: Soft but Functionally Rigid. ACS Appl Bio Mater 2024; 7:999-1016. [PMID: 38198289 DOI: 10.1021/acsabm.3c01000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Chronic wounds, such as burns and diabetic foot ulcers, pose significant challenges to global healthcare systems due to prolonged hospitalization and increased costs attributed to susceptibility to bacterial infections. The conventional use of antibiotic-loaded and metal-impregnated dressings exacerbates concerns related to multidrug resistance and skin argyrosis. In response to these challenges, our research introduces a unique approach utilizing antibiotic-free smart hydrogel wound dressings with integrated infection eradication and diagnostic capabilities. Electrospinning stands out as a method capable of producing hydrogel nanofibrous materials possessing favorable characteristics for treating wounds and detecting infections under conditions utilizing sustainable materials. In this study, innovative dressings are fabricated through electrospinning polycaprolactone (PCL)/gelatin (GEL) hybrid hydrogel nanofibers, incorporating pDA as a cross-linker, εPL as a broad-spectrum antimicrobial agent, and anthocyanin as a pH-responsive probe. The developed dressings demonstrate exceptional antioxidant (>90% radical scavenging) and antimicrobial properties (95-100% killing). The inclusion of polyphenols/flavonoids and εPL leads to absolute bacterial eradication, and in vitro assessments using HaCaT cells indicate increased cell proliferation, decreased reactive oxygen species (ROS) production, and enhanced cell viability (100% Cell viability). The dressings display notable alterations in color that correspond to different wound conditions. Specifically, they exhibit a red/violet hue under healthy wound conditions (pH 4-6.5) and a green/blue color under unhealthy wound conditions (pH > 6.5). These distinctive color changes provide valuable insights into the versatile applications of the dressings in the care and management of wounds. Our findings suggest that these antibiotic-free smart hydrogel wound dressings hold promise as an effective and sustainable solution for chronic wounds, providing simultaneous infection control and diagnostic monitoring. This research contributes to advancing the field of wound care, offering a potential paradigm shift in the development of next-generation wound dressings.
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Affiliation(s)
- Raj Kumar Sen
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Priyanka Prabhakar
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Shruti
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Priya Verma
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-National Botanical Research Institute, Rana Pratap Marg, Lucknow 226001, India
| | - Apeksha Vikram
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Aradhana Mishra
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-National Botanical Research Institute, Rana Pratap Marg, Lucknow 226001, India
| | - Ashish Dwivedi
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Vijay Sorna Gowri
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Jamuna Prasad Chaurasia
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Dehi Pada Mondal
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Avanish Kumar Srivastava
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Neeraj Dwivedi
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Chetna Dhand
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal 462026, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Parihar A, Sharma P, Choudhary NK, Khan R, Gupta A, Sen RK, Prasad HC, Ashiq M. Green Synthesis of CdS and CdS/rGO Nanocomposites: Evaluation of Electrochemical, Antimicrobial, and Photocatalytic Properties. ACS Appl Bio Mater 2023; 6:3706-3716. [PMID: 37674302 DOI: 10.1021/acsabm.3c00390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
The green approach has been employed for the synthesis of various types of nanomaterials including metal nanoparticles, metal oxides, and carbon-based nanomaterials. These processes involve natural sources that contain bioactive compounds that act as reducing, stabilizing, and capping agents for the formation and stabilization of nanomaterials. This study reports the green synthesis of CdS and CdS/rGO nanocomposites using Lactobacillus bacteria. The UV-visible spectrophotometer, field emission scanning electron microscopy, transmission electron microscopy, energy-dispersive X-ray spectroscopy, Raman spectroscopy, and Fourier transform infrared spectroscopy spectra confirm the synthesis of the nanocomposite. The electrochemical characterization using cyclic voltammetry, differential pulse voltammetry, and EIS revealed that the CdS/rGO nanocomposites showed a higher electron transfer rate compared with CdS nanoparticles, indicating the potential of the nanocomposites for biosensing applications. The zone of inhibition revealed significant antimicrobial activity against Escherichia coli and Staphylococcus aureus for both CdS nanoparticles and CdS/rGO nanocomposites. Additionally, CdS/rGO nanoparticles exhibited high photocatalytic activity for the degradation of methylene blue dye. Overall, this study demonstrates that the synthesized CdS and CdS/rGO nanocomposites have good electrochemical properties, photocatalytic, and antimicrobial activity and, therefore, can be employed for various applications such as biosensing, photocatalysis, and antimicrobial activity.
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Affiliation(s)
- Arpana Parihar
- CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, Madhya Pradesh, India
| | - Palak Sharma
- NIMS Institute of Allied Medical Sciences and Technology, NIMS University, Jaipur 303121, Rajasthan, India
| | - Nishant Kumar Choudhary
- NIMS Institute of Allied Medical Sciences and Technology, NIMS University, Jaipur 303121, Rajasthan, India
| | - Raju Khan
- CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, Madhya Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Ayush Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, Madhya Pradesh, India
| | - Raj Kumar Sen
- CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, Madhya Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Harish Chandra Prasad
- CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, Madhya Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Mohammad Ashiq
- CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, Madhya Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Patel M, Bisht N, Prabhakar P, Sen RK, Kumar P, Dwivedi N, Ashiq M, Mondal DP, Srivastava AK, Dhand C. Ternary nanocomposite-based smart sensor: Reduced graphene oxide/polydopamine/alanine nanocomposite for simultaneous electrochemical detection of Cd 2+, Pb 2+, Fe 2+, and Cu 2+ ions. Environ Res 2023; 221:115317. [PMID: 36657597 DOI: 10.1016/j.envres.2023.115317] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/23/2022] [Accepted: 01/15/2023] [Indexed: 06/17/2023]
Abstract
Heavy metal ion (HMI) sensors are the most sought commercial devices for environmental monitoring and food analysis research due to serious health concerns associated with HMI overdosage. Herein, we developed an effective electrochemical sensor for simultaneous detection of four HMI (Cd2+, Pb2+, Fe2+, and Cu2+) using a ternary nanocomposite of reduced graphene oxide functionalized with polydopamine and alanine (ALA/pDA/rGO). Comprehensive spectroscopic and microscopic characterizations were performed to ensure the formation of the ternary nanocomposite. The developed nanocomposite on glassy carbon electrode (GCE) yields >2-fold higher current than GO/GCE electrode with excellent electrochemical stability and charge transfer rate. Using DPV, various chemical and electrochemical parameters, such as supporting electrolyte, buffer pH, metal deposition time, and potential, were optimized to achieve highly sensitive detection of targeted HMI. For Cd2+, Pb2+, Fe2+, and Cu2+ sensing devised sensor exhibited detection limits of 1.46, 2.86, 50.23, and 17.95 ppb and sensitivity of 0.0929, 0.0744, 0.0051, and 0.0394 μA/ppb, respectively, with <6% interference. The sensor worked similarly well for real water samples with HMI. This study demonstrates a novel strategy for concurrently detecting and quantifying multiple HMI in water and soil using a smart ternary nanocomposite-based electrochemical sensor, which can also detect HMI in food samples.
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Affiliation(s)
- Monika Patel
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Neha Bisht
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India
| | - Priyanka Prabhakar
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Raj Kumar Sen
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Pradip Kumar
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Neeraj Dwivedi
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Mohammad Ashiq
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - D P Mondal
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Avanish Kumar Srivastava
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Chetna Dhand
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal, 462026, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Prabhakar P, Sen RK, Patel M, Shruti, Dwivedi N, Singh S, Kumar P, Chouhan M, Yadav AK, Mondal DP, Solanki PR, Srivastava AK, Dhand C. Development of copper impregnated bio-inspired hydrophobic antibacterial nanocoatings for textiles. Colloids Surf B Biointerfaces 2022; 220:112913. [DOI: 10.1016/j.colsurfb.2022.112913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/23/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Sen RK, Prabhakar P, Bisht N, Patel M, Mishra S, Yadav AK, Venu DV, Gupta GK, Solanki PR, Ramakrishnan S, Mondal D, Srivastava AK, Dwivedi N, Dhand C. 2D Materials-Based Aptamer Biosensors: Present Status and Way Forward. Curr Med Chem 2021; 29:5815-5849. [PMID: 34961455 DOI: 10.2174/0929867328666211213115723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 11/22/2022]
Abstract
Current advances in constructing functional nanomaterials and elegantly designed nanostructures have opened up new possibilities for the fabrication of viable field biosensors. Two-dimensional materials (2DMs) have fascinated much attention due to their chemical, optical, physicochemical, and electronic properties. They are ultrathin nanomaterials with unique properties such as high surface-to-volume ratio, surface charge, shape, high anisotropy, and adjustable chemical functionality. 2DMs such as graphene-based 2D materials, Silicate clays, layered double hydroxides (LDHs), MXenes, transition metal dichalcogenides (TMDs), and transition metal oxides (TMOs) offer intensified physicochemical and biological functionality and have proven to be very promising candidates for biological applications and technologies. 2DMs have a multivalent structure that can easily bind to single-stranded DNA/RNA (aptamers) through covalent, non-covalent, hydrogen bond, and π-stacking interactions, whereas aptamers have a small size, excellent chemical stability, and low immunogenicity with high affinity and specificity. This review discussed the potential of various 2D material-based aptasensor for diagnostic applications, e.g., protein detection, environmental monitoring, pathogens detection, etc.
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Affiliation(s)
- Raj Kumar Sen
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Priyanka Prabhakar
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Neha Bisht
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Monika Patel
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Shruti Mishra
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Amit Kumar Yadav
- Special Centre for Nanoscience, Jawaharlal Nehru University, New Delhi 110067. India
| | - Divya Vadakkumana Venu
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Gaurav Kumar Gupta
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Pratima R Solanki
- Special Centre for Nanoscience, Jawaharlal Nehru University, New Delhi 110067. India
| | - Seeram Ramakrishnan
- Center for Nanofibers and Nanotechnology, Department of Mechanical Engineering, Faculty of Engineering, 2 Engineering Drive 3, National University of Singapore, Singapore, 117576. Singapore
| | - Dehipada Mondal
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | | | - Neeraj Dwivedi
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
| | - Chetna Dhand
- CSIR-Advanced Materials and Processes Research Institute, Hoshangabad Road, Bhopal. India
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Prabhakar P, Sen RK, Dwivedi N, Khan R, Solanki PR, Srivastava AK, Dhand C. 3D-Printed Microfluidics and Potential Biomedical Applications. Front Nanotechnol 2021. [DOI: 10.3389/fnano.2021.609355] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
3D printing is a smart additive manufacturing technique that allows the engineering of biomedical devices that are usually difficult to design using conventional methodologies such as machining or molding. Nowadays, 3D-printed microfluidics has gained enormous attention due to their various advantages including fast production, cost-effectiveness, and accurate designing of a range of products even geometrically complex devices. In this review, we focused on the recent significant findings in the field of 3D-printed microfluidic devices for biomedical applications. 3D printers are used as fabrication tools for a broad variety of systems for a range of applications like diagnostic microfluidic chips to detect different analytes, for example, glucose, lactate, and glutamate and the biomarkers related to different clinically relevant diseases, for example, malaria, prostate cancer, and breast cancer. 3D printers can print various materials (inorganic and polymers) with varying density, strength, and chemical properties that provide users with a broad variety of strategic options. In this article, we have discussed potential 3D printing techniques for the fabrication of microfluidic devices that are suitable for biomedical applications. Emerging diagnostic technologies using 3D printing as a method for integrating living cells or biomaterials into 3D printing are also reviewed.
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Saini G, Sen RK, Kalia A, Kadam S. Implant-associated Hoffa's Fracture in a Floating Knee: A Case Report and Review of Literature. J Orthop Case Rep 2019; 9:79-83. [PMID: 31559235 PMCID: PMC6742877 DOI: 10.13107/jocr.2250-0685.1432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Complex floating knee in the presence of a previous implant creates an unusual fracture pattern which is a rare entity and poses a unique challenge in management and subsequent rehabilitation. Case Report: A 56-year-old psychiatric patient who jumped from height had a polytrauma and a floating knee injury. Following the primary care and damage control surgery with knee-spanning fixator at some other centers, he was shifted to us on ventilator care and was directly admitted to intensive care unit for further management. On presentation, it was a floating knee injury with gross comminution of both femur and tibia with associated Hoffa with bent implant in situ. It was managed by plating of both lower end femur and tibia and at the end of 6 months, showed a satisfactory outcome. Conclusion: Floating knee injuries further complicated by the presence of the previous implant in a polytrauma situation poses a unique challenge which requires meticulous surgical planning and prolonged rehabilitation to achieve satisfactory outcome.
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Affiliation(s)
- Gaurav Saini
- Department of Orthopaedics, Max Super Speciality Hospital, Mohali, Punjab, India
| | - R K Sen
- Department of Orthopaedics, Max Super Speciality Hospital, Mohali, Punjab, India
| | - Anoop Kalia
- Department of Orthopaedics, Max Super Speciality Hospital, Mohali, Punjab, India
| | - Sagar Kadam
- Department of Orthopaedics, Max Super Speciality Hospital, Mohali, Punjab, India
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Sen RK, Prakash S, Tripathy SK, Agarwal A, Sen IM. Inhalational Ciclesonide found beneficial in prevention of fat embolism syndrome and improvement of hypoxia in isolated skeletal trauma victims. Eur J Trauma Emerg Surg 2017; 43:313-318. [PMID: 26781645 DOI: 10.1007/s00068-016-0633-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/04/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Many studies have established intravenous corticosteroid as an effective prophylactic therapy in fat embolism syndrome (FES). However, its use is limited among surgeons because of systemic side effects. Inhalational steroids have least systemic effects and are widely used for several chest conditions (i.e., asthma), but their effectiveness in FES has not been established. QUESTION/PURPOSE This study was sought to evaluate the (1) efficacy and (2) safety of inhalational Ciclesonide (CIC) in prevention of FES and treatment of hypoxemia in isolated skeletal trauma victims. METHODS A nonrandomized prospective control trial was designed in which all patients between 18 and 40 years with isolated skeletal injury who presented within 8 h of injury were allocated to either Trial group or control group. Trial group patients received 640 mcg of inhalational CIC with a metered-dose inhaler at the time of admission, and at 24 h. Control group patients did not receive any prophylactic therapy. Both groups were evaluated for development of FES (Gurd's criteria) and hypoxemia (PaO2 <70 mmHg) for 72 h. The complications related to CIC administration were evaluated in trial group patients during their hospital stay. RESULTS Of 35 patients in each group, two patients in Trial group and nine patients in control group developed FES (P = 0.022). Eight patients in Trial group had hypoxemia at the time of admission, six of them improved and one additional patient developed hypoxemia after inhalational CIC administration. In control group, ten patients had hypoxia at the time of admission, only one of them improved and remaining nine patients had persistent hypoxemia even after 72 h. Additionally, three patients developed hypoxemia. A significant improvement in hypoxemia and a significant decrease in the incidence of FES were observed in Trial group (P < 0.05) compared to control group. None of the patients presented with any complications or adverse effects of steroid in Trial group. CONCLUSION Inhalational CIC is a safe and effective therapy for prevention of FES and also an effective drug for treatment of hypoxemia in orthopedic trauma victims. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- R K Sen
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - S Prakash
- Department of Orthopaedics, Ex-resident Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S K Tripathy
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
- Department of Orthopaedics, AIIMS, Bhubaneswar, 751019, India.
| | - A Agarwal
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - I M Sen
- Department of Anesthesia and Critical Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
INTRODUCTION Neglected pelvic fractures manifesting as pelvic nonunion or malunion are usually due to inadequate initial fixation or negligence of the injury because of increased attention towards other associated life-threatening conditions. The management of such injuries is complex. A systematic review was conducted to spot the clinical manifestations, evaluation, management and outcome of pelvic nonunion and malunion. MATERIALS AND METHODS Two databases ("Pubmed" and "Google scholar") were searched to look for relevant literature on pelvic non-union and malunion. The search was limited to 'English language' and 'Human being'. RESULTS A total of 500 articles found, of which 10 articles were only reviewed which met the inclusion criteria. These articles discussed the clinical management and treatment of pelvic malunion and non-union following trauma without associated acetabular injury. CONCLUSION The usual presentations of pelvic non-union and malunion are pain, deformity, gait abnormality or instability. A detailed preoperative evaluation is essential as a majority of them have associated hip and spine injury which may be the cause of symptoms. Radiographs and 3D CT scans have helped surgeons in deciding the best way of management. The surgeries are usually complex and may need multiple-staged procedures. Soft tissue release, multiple osteotomies to achieve anatomical or near-anatomical reduction, augmentation of healing process using bone graft and stabilizing the nonunion/ osteotomy site using plates/screws/rods is the basic principle of surgery. Per-operative use of somato-sensory evoked potential evaluation helps the surgeon in preventing iatrogenic nerve injury. Despite these precautions and surgeries, most of the patients do not regain their preinjury functional activity.
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MESH Headings
- Female
- Fracture Fixation, Internal/adverse effects
- Fracture Fixation, Internal/methods
- Fracture Healing/physiology
- Fractures, Bone/diagnostic imaging
- Fractures, Bone/surgery
- Fractures, Malunited/diagnostic imaging
- Fractures, Malunited/etiology
- Fractures, Malunited/surgery
- Fractures, Ununited/diagnostic imaging
- Fractures, Ununited/etiology
- Fractures, Ununited/surgery
- Humans
- Male
- Pelvic Bones/diagnostic imaging
- Pelvic Bones/injuries
- Pelvic Bones/surgery
- Postoperative Complications/epidemiology
- Postoperative Complications/surgery
- Prognosis
- Radiography
- Risk Assessment
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Affiliation(s)
- S K Tripathy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India,
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Abstract
Management of neglected acetabular fractures is a difficult task. Osteosynthesis in such cases may not be an ideal solution because of the femoral head damage due to pressure by the fractured acetabular edge, avascular necrosis, difficulty in mobilizing the fragments due to callus formation, difficulty in indirect reduction of the fracture fragments and macerated acetabular fragments all contributing to inadequate fracture reduction. Majority of such fractures are now treated with total hip replacement. While treating such fractures with THR, problems associated with neglected acetabular fractures such as fracture non-union, hip dislocation, protrusio, cavitary bone defect or peripheral bone defect must be considered. 3D computed tomography scan provides a clear view about the acetabular and periacetabular bony anatomy. Impaction grafting and antiprotrusio cage or ring with a cemented acetabular cup can address most of the hip protrusio and cavitary bone defects. Segmental bone defect needs cortical strut-bone graft fixation and subsequent implantation of a cemented or uncemented acetabular cup implantation. Fracture non-union needs approximate reduction and fixation with plates followed by bone grafting and implantation of an acetabular cup. Despite these efforts, the outcome of THR in neglected acetabular fracture is considerable worse than after conventional hip replacement.
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MESH Headings
- Acetabulum/diagnostic imaging
- Acetabulum/injuries
- Acetabulum/surgery
- Arthroplasty, Replacement, Hip/methods
- Female
- Fracture Fixation, Internal/adverse effects
- Fracture Fixation, Internal/methods
- Fractures, Bone/complications
- Fractures, Bone/diagnostic imaging
- Fractures, Bone/surgery
- Fractures, Ununited/diagnostic imaging
- Fractures, Ununited/etiology
- Fractures, Ununited/surgery
- Hip Dislocation/diagnostic imaging
- Hip Dislocation/etiology
- Hip Dislocation/surgery
- Humans
- Injury Severity Score
- Male
- Monitoring, Physiologic/methods
- Osteoarthritis, Hip/diagnostic imaging
- Osteoarthritis, Hip/etiology
- Osteoarthritis, Hip/surgery
- Pain Measurement
- Radiography
- Range of Motion, Articular/physiology
- Recovery of Function
- Risk Assessment
- Time-to-Treatment
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Meena UK, Tripathy SK, Sen RK, Aggarwal S, Behera P. Predictors of postoperative outcome for acetabular fractures. Orthop Traumatol Surg Res 2013; 99:929-35. [PMID: 24183746 DOI: 10.1016/j.otsr.2013.09.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 08/19/2013] [Accepted: 09/06/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND The outcomes of surgically treated acetabular fractures are dependent on many factors. The purpose of this retrospective study is to evaluate these factors in a group of patients operated on by a single surgeon in one institute. METHODS One hundred and eighteen patients, treated surgically for their displaced acetabular fracture and who had completed two years follow-up, were evaluated clinically with Modified Postel Merle d'Aubigné score and radiologically with Matta's radiological outcome grading. The effect of age (≤ 55 or >55 years), gender, fracture displacement (≤ 20mm or >20mm), hip dislocation, delay in surgery (≤ 2 weeks or >2 weeks), associated injury and length of follow-up (≤ 5 years or >5 years) on the functional outcome was evaluated. RESULTS There were 99 (83.9%) males and 19 (16.1%) females with mean age of 38.75 years (16 to 65 years). The mean duration of follow-up was 3.95 years (range 2 to 14 years). The mean Modified Postel Merle d'Aubigné score was 15.7 ± 2.2 (range, 8 to 18). The clinical outcome was excellent in 27 (22.9%), good in 52 (44.2%), fair in 20 (16.9%), and poor in 19 (16.1%, 10 patients who underwent THR for secondary arthritis were considered as poor outcome) patients. The Modified Postel Merle d'Aubigné score was significantly affected by quality of reduction (P=0.0001), presence of associated injuries (P=0.0001), initial fracture displacement of >20mm (P=0.018), joint dislocation (P=0.015) and delay in surgery (P=0.001). However, age, gender, fracture type and length of follow-up did not have any effects on the clinical outcome. CONCLUSION Poor reduction, associated injuries, fracture displacement of >20mm, joint dislocation and late surgery definitely carry poor prognosis in predicting the outcome of surgically treated acetabular fractures.
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Affiliation(s)
- U K Meena
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India
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Perumal V, Banerjee S, Das S, Sen RK, Mandal M. Effect of liposomal celecoxib on proliferation of colon cancer cell and inhibition of DMBA-induced tumor in rat model. Cancer Nanotechnol 2011; 2:67-79. [PMID: 26069486 PMCID: PMC4451972 DOI: 10.1007/s12645-011-0017-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 06/29/2011] [Indexed: 02/06/2023] Open
Abstract
Celecoxib, a selective cyclooxygenase-2 inhibitor, has shown potential anticancerous activity against majority of solid tumors especially on patients with colon cancer. However, associations of serious side effects limit the usage of celecoxib in colon cancer treatment. To address this issue and provide an alternative strategy to increase the efficacy of celecoxib, liposomal formulation of celecoxib was prepared and characterized. Anticancer activity of liposomal celecoxib on colon cancer cell HCT 15 was evaluated in vitro. Furthermore, tumor inhibition efficiency by liposomal celecoxib was studied on 7,12-dimethyl benz(a)anthracene (DMBA)-induced tumor in rat model. In order to elucidate the antioxidant activity of celecoxib-loaded liposomes, antioxidant superoxide dismutase (SOD) generation and lipid peroxide (LPx) formation in both liver and kidney tissues were examined. Characterization of the formed unilamellar liposomes revealed the formation of homogeneous suspension of neutral (empty) or anionic (celecoxib-loaded) liposomes with a well-defined spherical shape which have a mean size of 103.5 nm (empty liposome) and 169 nm (liposomal celecoxib). High-performance liquid chromatography (HPLC) analysis and hemolytic assay demonstrated 46% of celecoxib entrapment efficiency and significantly low hemolysis, respectively. Liposomal celecoxib exhibited dose-dependent cytotoxicity and apoptotic activity against HCT 15 cells which are comparable to free celecoxib. In vivo study demonstrated inhibition of tumor growth. Biochemical analysis of the liposomal celecoxib-treated group significantly inhibited the LPx formation (oxygen-free radicals) and increased the activity of SOD. Our results present the potential of inhibiting colon cancer in vitro and DMBA-induced tumor in rat model in vivo by liposomal celecoxib.
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Affiliation(s)
- Venkatesan Perumal
- School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India 721302 ; Nanotech Research Facility, PSG Institute of Advanced Studies (PSGIAS), Coimbatore, India 641 004
| | - Shubhadeep Banerjee
- School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India 721302
| | - Shubasis Das
- Department of Biotechnology, Indian Institute of Technology, Kharagpur, India 721302
| | - R K Sen
- Department of Biotechnology, Indian Institute of Technology, Kharagpur, India 721302
| | - Mahitosh Mandal
- School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India 721302
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Sen RK, Gul A, Aggarwal S, Kumar SR, Nagi ON. Comminuted refracture of the distal femur and condyles in patients with an intramedullary nail: a report of 5 cases. J Orthop Surg (Hong Kong) 2005; 13:290-5. [PMID: 16365494 DOI: 10.1177/230949900501300313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with in situ intramedullary nails sustaining a second distal femoral fracture following high-velocity trauma are infrequently reported in the literature. We report 5 such patients who sustained a second injury after 6 to 24 months, resulting in another fracture at the nail-tip level. These second fractures severely comminuted the femoral condyles. These patients required removal of the intramedullary nail, reconstruction of the comminuted femoral condyles, and stabilisation using an angled or buttress plate. Four of the 5 patients were followed up for a mean period of 36 months and were evaluated for knee status and outcome using Judet's criteria. Postoperative knee stiffness was common, and further interventions such as manipulation, hardware removal, arthrolysis, and quadricepsplasty were needed. One patient was lost to follow-up. The final results of the knees were good, with more than 100 degrees range of movement. It is important to adhere to established internal fixation protocols in the treatment of these complex nail tip fractures.
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Affiliation(s)
- R K Sen
- Department of Orthopaedic surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Traumatic anterior dislocation of the hip is an uncommon injury and bilateral anterior dislocation of the hip is still rare. A case is described of hitherto unreported simultaneous bilateral anterior iliac hip dislocation, complicated by fracture of the femoral head on one side. The extreme rarity of this fracture and the peculiar mechanism of injury (the treatment planning and the post reduction protocol) make this case worth reporting. (Hip International 2004; 14: 196-8).
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Affiliation(s)
- R K Sen
- Department of Orthopaedic Surgery, Post Graduate Institute of Medical Education and Research, Chandi
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Abstract
Seven patients seen with fracture separation of the distal humerus epiphysis have been analysed for the problems linked with the radiological diagnosis of this injury. Peculiar male predominance, exclusive left-side involvement, consistent postero-medial displacement of the epiphyseal fragment and ability to achieve near anatomic reduction by closed manipulation in fresh cases have been some of the other features observed. The literature has been briefly reviewed for this infrequent and usually misdiagnosed injury.
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Affiliation(s)
- R K Sen
- Department of Orthopaedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Sen RK, Yadav RS, Sharma LR, Thakur SR. Giant cell tumour of talus. J Indian Med Assoc 1990; 88:16-7. [PMID: 2362133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- R K Sen
- Department of Orthopaedic Surgery, IG Medical College, Shimla
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Abstract
A new patellar angle is described in lateral radiographs of the knee joint. One line is drawn along the articular surface of the patella and another from the end of the inferior articular cartilage to the patellar apex. The angle formed by these two lines averaged 33 degrees in 68 knees joints afflicted with Osgood-Schlatter disease and 47 degrees in 71 age-matched controls and 198 adult controls. The small angle in Osgood-Schlatter disease is proposed to be an important factor in the pathogenesis of the traction apophysitis.
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Affiliation(s)
- R K Sen
- Department of Orthopedics, Indira Gandhi Medical College, Shimia, India
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Khanna BK, Mukerji PK, Sen RK. Diagnostic value of scalene node biopsy in pulmonary tuberculosis. Br J Dis Chest 1968; 62:211-4. [PMID: 5699826 DOI: 10.1016/s0007-0971(68)80017-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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